Maine General Health (MGH) is a rural Health System in Central Maine committed to the implementation of an outpatient electronic medical record (EMR). In the year 2000, a process was launched to evaluate our local provider's needs and choose a product. To date, the EMR has been implemented at 7 sites. The pilot project ties together information and practice systems of four partner organizations including primary care clinics in distant geographic locations, a family practice residency program and specialty clinics at the two primary hospitals in the health system. Implementation of the EMR was separated into distinct phases to match the expected learning curve and to reduce the potential loss of practice productivity often associated with an EMR. Funding is sought to improve the Team, the Tools, and the Data to improve the scope, quality, speed, visibility, and demonstration value of the project. The organizations partnered to this set of projects and to this grant application share a commitment to the health of all residents of all communities in the Greater Kennebec Valley of Maine. The partners recognize the need and opportunity to improve safety, quality, access, and cost of healthcare in the region and recognize the potential value of a unifying foundation of information and information technology. During the grant period the EMR implementation team will complete the primary implementation, improve structure and usage in the implemented practices, implement the Electronic Medical Record in one new practice per quarter, and collect data about patient safety, quality, access, cost, and productivity.